Urticaria rash rheumatology

Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin

Photosensitivity, Butterfly rash ... Vasculitis, Purpura, Urticaria ... symptoms #diagnosis #rheumatology

Adult Onset Still's Disease
Systemic inflammation with urticarial rash.
Rash:
• Nonpruritic, evanescent (correlates with time of

inflammation with urticarial ... rash. ... Rash: • Nonpruritic ... maculopapular skin rash ... AOSD #diagnosis #rheumatology

Dermatologic Manifestations of Granulomatosis with Polyangiitis (GPA)

Skin involvement in granulomatosis with polyangiitis (GPA) is common and

Maculopapular rash ... gangrenosum) • Urticaria ... #dermatology #rash ... #diagnosis #rheumatology

Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
•

Hypocomplementemic Urticarial ... Vasculitis): - Urticaria ... mucositis - Rash ... cryoglobulinemia, urticarial ... differential #diagnosis #rheumatology

Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,

, mucositis • Rash ... Hypocomplementemia: Urticarial ... Hypocomplementemic Urticarial ... maculopapular lesions, urticaria ... Differential #Diagnosis #Rheumatology

Diagnosis and Management of Hypocomplementemic Urticarial Vasculitis (HUV)

Diagnosis of HUV
1) Chronic urticaria
2) Leukocytoclastic vasculitis
3)

Hypocomplementemic Urticarial ... HUV 1) Chronic urticaria ... Hypocomplementemic #Urticarial ... Diagnosis #Management #Rheumatology

Severe Urticarial Skin Rash on Physical Exam

#Urticarial #Skin #Rash #PhysicalExam #clinical #video #dermatology #urticaria

Severe Urticarial ... Skin Rash on Physical ... Exam #Urticarial ... #Skin #Rash #PhysicalExam ... #dermatology #urticaria

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Cold Urticaria
Prevalence - 0.05% in the population
Disease onset - Mostly 2nd to 4th decades of life
Causes

Cold Urticaria Prevalence ... Chronic spontaneous urticaria ... Chronic inducible urticarias ... .14674 #Cold #Urticaria ... #diagnosis #rheumatology

Urticaria Multiforme - Generalized polycyclic annular rash with wheals and ecchymotic centers (Panel A). Physical examination

Urticaria Multiforme ... polycyclic annular rash ... blanching arcuate urticarial ... rash (Panels B ... Clinical #Derm #Urticaria

Pathophysiology of Hypocomplementemic Urticarial Vasculitis

C1q/anti-C1q antibiody ->
Immune Complex Formation - Complement Pathway Activation (C3a and C5a)

Hypocomplementemic Urticarial ... Hypocomplementemic #Urticarial ... Pathophysiology #Rheumatology

Vasculitis Involving the Skin - Differential Diagnosis Framework

Primary: 50% Cutaneous Vasculitis: Leukocytoclastic Vasculitis
Secondary: CTD: SLE, RA

bullae, Ulceration, Urticaria ... - Anti-C1q (Urticarial ... #dermatology #rheumatology

Reactive Skin Rash - Differential Diagnosis Algorithm
Reactive erythematous with various morphology
• Urticaria - Firm /

Reactive Skin Rash ... morphology • Urticaria

I’M DAMN SHARP - Lupus Diagnosis Mnemonic
I Immunoglobulins (Anti-dsDNA, Anti-Sm, Anti-phospholipid)
M Malar Rash
D

Anti-phospholipid) M Malar Rash ... D Discoid Rash ... erythematosus #rheumatology

Urticaria Mimics

Conditions That May Be Confused with Urticaria

Arthropod bites
, Atopic dermatitis
, Bullous pemphigoid
,

Urticaria Mimics ... Confused with Urticaria ... Pityriasis rosea , Urticaria ... #Differential #Urticaria

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Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology

Erythematosus #SLE #hematology ... #rheumatology #

Dematoses in Pregnancy - Specific Skin Conditions
Non-Pruritic
• Pustular psoriasis of pregnancy
• Impetigo Herpetiformis
Pruritic -

gestationis • Pruritic urticarial ... dermatoses #pregnancy #rash

Autoimmune Myositis
Necrotizing myopathy is associated with higher CK levels, greater level of muscle weakness, less systemic

can present with rash ... including heliotrope rash ... Myositis #diagnosis #rheumatology

Extrapulmonary manifestations of COVID-19
• Neurologic: Headaches, Dizziness, Encephalopathy, Guillain-Barré, Ageusia, Myalgia, Anosmia, Stroke
• Renal:

, Erythematous rash ... , Urticaria, Vesicles

Urticaria (hives): Skin reaction that occurs in response to cold, food allergies, meds, environmental exposures, stings,
infections

Urticaria (hives ... Dermatology #SkinRash #Urticaria

Acute Schistosomiasis: Katayama Fever
• Most common in travelers and children
• "Swimmers Itch" in the

extremities, papular or urticarial ... rash • Systemic

Skin Conditions Associated with Joint Pain

Rash
• Human parvovirus B19 infection

Malar rash
• SLE
• Human parvovirus B19 infection
•

Joint Pain Rash ... infection Malar rash ... differential #diagnosis #rheumatology

Penicillin Allergy Pathway for Antibiotic Prescription in Patients With Penicillin Allergy
Mild Reaction - Itching, Minor rash

Itching, Minor rash ... Maculopapular rash ... Hypotension, Hives/urticaria ... nephritis, Drug rash

Rash Morphology Description Algorithm

#Rash #Morphology #Description #Algorithm #Skin #Dermatology #Diagnosis

Rash Morphology ... Algorithm #Rash

Palpable Rash Algorithm ... #Palpable #Rash

An Approach to the Unknown Rash: Petechial-Purpuric Rash
#Diagnosis #Dermatology #Petechial #Purpura #Purpuric #Rash #Palpable #Algorithm

to the Unknown Rash ... Petechial-Purpuric Rash ... Purpura #Purpuric #Rash

Palpable Purpura - Rash Algorithm
#Diagnosis #Dermatology #Rash #Palpable #Purpura #Differential #Algorithm

Palpable Purpura - Rash ... #Dermatology #Rash

RASHonal Approach to a Rash

- Dr. Arielle Klepper @ https://twitter.com/ArielleKlepper

#Rash #Algorithm #RASHonal #Differential #Diagnosis #Classification #Skin

Approach to a Rash ... ArielleKlepper #Rash

Thrombocytosis - Differential Diagnosis
Platelet Count > 450
Reactive:
• Anemia/blood loss (Fe deficiency)
• Infection/Sepsis
• Non-infectious

Non-infectious (malignancy, rheumatologic ... causes #Platelets #hematology

Stepwise Treatment of Chronic Urticaria
Step 1 - Start second-generation HI antihistamine

Step 2 - One or

Treatment of Chronic Urticaria ... Management #Chronic #Urticaria

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Practical Pediatric Viral Rash Algorithm

Child presenting with rash and current/ recent symptoms of viral illness but

Pediatric Viral Rash ... presenting with rash ... sailordoctor #Rash

Manifestations of Anaphylaxis by Body System

Dermatologic/mucosal

- Eyes: periorbital swelling/erythema, injected conjunctiva, tears

- Oral mucosa:

lips - Skin: urticarial ... rash, pruritus ... , morbilliform rash

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Causes of Urticaria

Immunoglobulin E (IgE) mediated

- Aeroallergens

- Contact allergen

- Food allergens

- Insect

Causes of Urticaria ... #Differential #Urticaria

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Classification of Vasculitis
Vasculitis of large vessels
- Arteritis temporalis (giant-cell arteritis)
- Takayasu

hypocomplementary urticarial ... Vessels #Diagnosis #Rheumatology

An Approach to the Unknown Rash: Erythematous Rash

#Diagnosis #Dermatology #Erythematous #Rash #Differential #Algorithm #Nikolsky #Sign

to the Unknown Rash ... : Erythematous Rash ... #Erythematous #Rash

An Approach to the Unknown Rash: Vesiculobullous Rash
#Diagnosis #Dermatology #Vesicular #Vesicles #Vesiculobullous #Rash #Algorithm #AFebrile

to the Unknown Rash ... Vesiculobullous Rash ... Vesiculobullous #Rash

Algorithmic Guide to Tick-Borne Illnesses in the United States - By Major Symptoms (Fever, Rash, Lymphadenopathy)

Symptoms (Fever, Rash ... #Ticks #Fever Rash

Monkeypox Vesicular Rash on Skin Exam

#Monkeypox #Rash #Skin #PhysicalExam #clinical #vesicles #dermatology

Monkeypox Vesicular Rash ... #Monkeypox #Rash

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Causes of Petechial Rash - Differential Diagnosis Algorithm

Pinpoint areas (less than 2 mm) of hemorrhage, which

Causes of Petechial Rash ... : • Palpable Rash ... • Non-Palpable Rash ... : • Palpable Rash ... • Non-Palpable Rash

Syphilis Rash on Palms and Soles

#Syphilis #Rash #Palms #Soles #clinical #dermatology #skin #secondary #PhysicalExam

Syphilis Rash on ... #Syphilis #Rash

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Presenting with Rash

Blisters #Bullae #Rash

Algorithm for Diagnosis of the Petechial / Purpuric Rash

Febrile/Toxic, Palpable:
- Meningococcaemia, Disseminated Gonococcal Infection,

Petechial / Purpuric Rash ... Petechiae #Purpura #Rash

Vesiculobullous Rashes - THE ALGORITHMIC APPROACH
Vesiculobullous rashes provoke significant angst
in many physicians (Figure 5, page

noting whether the rash ... vesiculobullous rash ... vesiculobullous rash ... vesiculobullous rash ... Vesiculobullous #Rash

Name that rash.

Heliotrope Rash in Dermatomyositis

Peri-orbital edema and the heliotrope rash that we are all familiar with. Eyelid

Heliotrope Rash ... the heliotrope rash ... The heliotrope rash ... #Heliotrope #Rash

Algorithm for Diagnosis of the Vesiculobullous Rash

Febrile, Diffuse Distribution:
- Varicella, Smallpox, Disseminated, Gonococcal,

Vesiculobullous Rash ... Vesiculobullous #Vesicular #Rash

Adult-Onset Still's Disease
Clinical triad: Fever, Arthralgia/arthritis, Skin rash ± odynophagia
+ Biological inflammation: Increased neutrophils, Hyperferritinemia, decreased

arthritis, Skin rash ... management #treatment #rheumatology

Combination of Skin Findings and Arthritis in Pediatrics Patient - Differential Diagnosis
Malar rash:
• A

Diagnosis Malar rash ... erythematous raised rash ... Lupus Discoid rash ... serpentinous like rash

Secondary Syphilis Rash
Secondary syphilis is the most contagious of all the stages of this disease, and

Secondary Syphilis Rash ... Skin rash and malaise ... ▪ “Rash” (75% ... Characteristic rash ... characteristic rash

InfectiousDisease #Measles #Rash

Vesicular or Pustular Rash

Clinical Features and Complications of Measles

Rash:
Spreads downwards, from behind the ears to the whole Of the

of Measles Rash ... maculopapular rash

Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
• Epidemiology: 10-180/100,000, Typically Age 20-40, F:M

Manifestations: Malar rash ... Management #Summary #rheumatology

Myositis and Myopathies
Polymyositis
• Progressive, symmetric muscle weakness
• Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis

muscle weakness, rash ... diagnosis #comparison #rheumatology

Angioedema - Classification Diagnosis and Treatment
Types of Angioedema:
• Acute allergic angioedema - Usually occurs with

Usually occurs with urticaria ... usually occurs with urticaria

Management #Algorithm #rheumatology

Sweet’s Syndrome - Acute febrile neutrophilic dermatosis

The syndrome involves fever, painful rash, neutrophilic leukocytosis, and

fever, painful rash ... #dermatology #Rash

Generalized Algorithm for the Evaluation of Dermatologic Processes - Branches: Erythroderma Petechial Fluid-Filled Maculopapular

#Diagnosis #Dermatology

#Dermatology #Rash

Fever and Rash - Differential Diagnosis Framework
• Viral: Measles, Infectious Mono (EBV, CMV), Acute HIV,

Fever and Rash - ... SCVMCMed #Fever #Rash

Symptoms #Diagnosis #rheumatology

Acute Purpura Fulminans Skin Rash on Physical Exam
60 year old male ITP s/p splenectomy
1d

Fulminans Skin Rash ... new full-body rash ... can lead to the rash ... Fulminans #Skin #Rash

Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and

everywhere) 2) A rash ... 6) An annular rash ... erythematosus #rheumatology

Rubella (German Measles)
Rubella, also called German measles, often presents with a mild febrile illness with a

maculopapular rash ... Erythematous papular rash

fingers #hands #rheumatology

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Clinical Manifestations of Systemic Lupus Erythematosus (SLE)

#Systemic #Lupus #Erythematosus #SLE #Manifestations #Signs #Symptoms #Rheumatology #Diagnosis

Signs #Symptoms #Rheumatology

#Dermatology #Rash

Baclofen Skin Rash

When a nursing home patient re-presents to the Emergency Department, go through their medication

Baclofen Skin Rash ... Baclofen #Skin #Rash

NAFLD / NASH Progression Timeline
Healthy Liver → NAFLD/NASH → 0.25-3.2%/year → Cirrhotic NASH → 0.3-2.6%/year →

NAFLD / NASH Progression ... Liver → NAFLD/NASH ... year → Cirrhotic NASH ... → HCC • NAFLD/NASH ... → Cirrhotic NASH

Pruritus - Primary Skin Lesion - Differential Diagnosis Algorithm
Macules / Papules / Plaques:
• Xerosis (dry

Wheals/Hives: • Urticaria

Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?

→ Refer to hematology ... Inflammatory Conditions: Rheumatologic ... Diagnosis #Algorithm #hematology

Management #GCA #rheumatology

Systemic Lupus Erythematosus - Diagnosis
Manifestations:
- Arthritis 69%
- Malar rash 40%
- Fever 36%
-

69% - Malar rash ... #differential #rheumatology

RUSH Protocol: Rapid Ultrasound for Shock and Hypotension

Infographic by Dr. Jonny Wilkinson @Wilkinsonjonny

#RUSH #Protocol #Rapid

RUSH Protocol: Rapid ... Wilkinsonjonny #RUSH

differential #types #rheumatology

Approach to the Rash in a an oncology patient - MINT-C Mnemonic
M - Malignancy: Leukemia cutis,

Approach to the Rash ... dermatoses #skin #Rash

ICU Sedation Scales (RASS and modified Ramsay Sedation Scales)
Richmond Agitation-Sedation Scale (RASS) #Diagnosis #Nursing #RASS #Richmond

Sedation Scales (RASS ... Agitation-Sedation Scale (RASS ... Diagnosis #Nursing #RASS

This is a cheat sheet for medical students rotating in dermatology or residents needing help with

dermatology #skin #rash

$Maculopapular Rashes - THE ALGORITHMIC APPROACH The term maculopapule is a portmanteau, a combination of macule and$

distribution of the rash ... and whether the rash ... peripherally distributed rash ... Maculopapular #Rash

Medications for Treatment of Acute Gout
- NSAIDs
- Colchicine (Colcrys)
- Corticosteroids
#Acute #Gout #Medications #Treatment

Management #AAFP #Rheumatology

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Treatment of Thrombotic Thrombocytopenic Purpura (TTP)
Diagnosis of TTP:
• Rare and severe, ADAMTS13 deficiency
• Autoimmune

management #treatment #rheumatology ... #hematology

Multiple dermatology H&P cheat sheets for the medical student rotating in dermatology or residents needing help

dermatology #skin #rash

Gout Management in CKD
• Colchicine
• NSAID
• Glucocorticoid
• ACTH
• Interleukin-1 Inhibitors

#Gout #Management

Management #CKD #rheumatology

Characteristic rash

Arthralgia #Diagnosis #Rheumatology

Fluid-filled Rash - Diagnostic Algorithm. Pustule: 1) Pustules more commonly suggest an infectious process (bacterial,

Fluid-filled Rash ... #Dermatology #Rash

size #Diagnosis #Rheumatology

Clinical manifestations of anaphylaxis.
Neurological (<15%): Dizziness, syncope, seizures, Confusion, impending doom. headache
Angioedema: Lips, tongue, orbit,

Mucosa 80-90%): Urticaria

Assessment of Nonalcoholic Steatohepatitis (NASH) Severity in Patients With Nonalcoholic Fatty
#Diagnosis #Pathology #NAFLD #NASH #Fibrosis #Staging

Steatohepatitis (NASH ... Pathology #NAFLD #NASH

Adult-Onset Still's Disease (AOSD)
Rare inflammatory disorder of unknown etiology, difficult to diagnose because of heterogenous presentation.

maculopapular rash ... Disease #AOSD #rheumatology

Focused Assessment with Sonography for HIV/TB - The FASH Exam

The main objective of the FASH exam

for HIV/TB - The FASH ... objective of the FASH ... Diagnosis #POCUS #FASH

ACR2021 #Management #rheumatology

Linear Rash in the Returning Traveler - Differential Diagnosis
Infectious:
• Cutaneous larva migrans
• Scabies (Sarcoptes

Linear Rash in the ... BoggildLab #Linear #Rash

Christmas Tree Rash of Pityriasis rosea
- small oval scaling patches
- Christmas tree pattern
-

Christmas Tree Rash ... ChristmasTree #Rash

Hydroxychloroquine - Risks and Benefits in Lupus
Benefits:
↓ Disease activity, ↓ Flare, ↓ Damage, ↓ Corticosteroid dose,

and aquagenic urticaria ... #sideeffects #rheumatology

Cryoglobulinemia Vasculitis #rheumatology

Stenosing Flexor Tenosynovitis or Trigger Finger on Physical Exam

Dr. Sergi Barrera @dr.sergibarrera

#TriggerFinger #Trigger #Finger #Stenosing #flexor

#orthopedics #rheumatology

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Rheumatoid Arthritis - ACR 2021 Guidelines
- Low Disease Activity
- Moderate to High Disease Activity

management #treatment #rheumatology

#Eosinophilic #rheumatology

Algorithm #Diagnosis #Hematology

Staphylococcal Scalded Skin Syndrome (SSSS)

A 5-year-old girl presents to the ED with a rash that started

the ED with a rash ... the patient’s rash

Diagnosis #Algorithm #hematology

Maculopapular - Diagnostic Algorithm
Pathophysiology:
- Catch-all term with a wide range of potential pathophysiologic mechanisms and causative

New-onset fever with rash ... #Dermatology #Rash

Diagnosis #Clues #Hematology

#Diagnosis #Hematology

Rasha Buhumaid @

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Syndrome - Adam Rosh

Simplified Coagulation Cascade and Differential Diagnosis

#Coagulation #Cascade #Differential #Diagnosis #Intrinsic #Extrinsic #Pathway #Hematology

Extrinsic #Pathway #Hematology

Pruritus - Generalized Differential Diagnosis Algorithm - Systemic and Primary Causes
== Primary Skin Lesions ==
Macules /

Wheals/Hives: • Urticaria

Intubation #Difficult #Crash

Cryptoglobulinemia Vasculitis #rheumatology

Anticonvulsants as Mood Stabilizers: Mechanism and Side-effect
Examples: Valproate, Carbamazepine, Lamotrigine
• Mild anticholinergic effect -> Drowsiness

reaction -> Benign Rash ... hyponatremia, rash

Anemia - Differential Diagnosis Framework
- Microcytic
- Normocytic
- Macrocytic

Khudhur M. @khudhur_moh

#anemia #differential #diagnosis #algorithm

diagnosis #algorithm #hematology

Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
• Epidemiology: -10% of all lupus cases, drug-dependent,

NPSLE rare, Malar rash ... Manifestations: Malar rash ... comparison #table #rheumatology

Pathophysiology #hematology

Pathophysiology #Hematology

Causes #Algorithm #Hematology

diagnosis #comparison #rheumatology

CompleteBloodCount #Hematology

Disease #Algorithm #CRASH

Autoantibodies in Rheumatology
• Lupus (SLE): ANA (anti-nuclear antibody), dsDNA (double-stranded DNA), Anti-Smith, Anti-Ro (SSA) and

Autoantibodies in Rheumatology ... Autoantibodies #Rheumatology

Complement #Pathway #hematology

#Diagnosis #Hematology

FASH Exam - POCUS - Pictorial summary of the focused assessment with sonography for human immunodeficiency

FASH Exam - POCUS ... tuberculosis (HIV/ TB) - FASH ... Diagnosis #POCUS #FASH

Rasha Buhumaid @

Milk Hypersensitivity Allergy

This 6-month-old breast-fed infant developed an allergic reaction (a), with widespread urticaria immediately after

with widespread urticaria ... Widespread urticaria

with abd pain and rash

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Thrombocytopenia - Workup Algorithm
A common consult I receive.

Dr. Joseph Shatzel @Clotmaster

#Thrombocytopenia #Workup #Algorithm #Diagnosis #Differential #Hematology

#Differential #Hematology

Tick Associated Rash

Anaphylaxis: Signs and Symptoms
Anaphylaxis: when any egg of three conditions is met:
1. Acute onset of skin/mucosal

ischemia) • Urticaria

Hemolytic Anemia - Hemolysis Diagnostic Workup

Infographic by: Howard Ong

#Hemolysis #Hemolytic #Anemia #Algorithm #MAHA #TTP #Diagnosis #Workup

Diagnosis #Workup #Hematology

ITP #Management #Hematology

Types of hypersensitivity reactions

Type I - lgE-Mediated, Within I Hour (Anaphylaxis)
Type II - IgG or IgM

Days to Weeks (Rash

Erythematous Rashes - THE ALGORITHMIC APPROACH

Characterized by diffuse redness of the skin due to
capillary congestion, erythematous

erythematous rash ... #Erythematous #Rash

SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and

evidence of (fatigue, rash ... eruption - Butterfly rash ... Photosensitive rash ... Non-autoimmune rheumatologic ... Erythematosus #Diagnosis #Rheumatology